"New" Scientific Field and Its Implications for CAM?

A "New" Scientific Field and Its Implications for CAM?

In a paper, published online in Health Care Analysis, an International Journal of Health Care Philosophy and Policy, author Martyn D. Pickersgill from the Centre for Population Health Sciences, at the Medical School of the University of Edinburgh, in Scotland, argues for the value of the ‘new’ science of Science and Technology studies (STS).

She believes it will be valuable in shedding light on issues faced by bioethical scholars, who are concerned with the social, legal and philosophical implications of new and emerging science and medicine, as well as with the processes of research that under-pin these innovations.

Pickersgill explains that STS is concerned with the creation, standardisation, circulation, governance, implementation and claims to expertise regarding knowledge and technology. He applies these perspectives to ‘Medicine’.

Implications of Biomedicine

“... empirical STS research challenges the focus of bioethical scholarship concerned solely with the ‘implications’ of biomedicine (i.e. what effects innovation might and should have on science, medicine and society). It does this through highlighting the diverse ‘regimes of normativity’ within which actors are embedded, and the degree to which moral and ethical decision-making and action is a constitutive dimension of work and everyday life.”

In this paper Pickersgill acknowledges that many medical practitioners and researchers might see STS as a confrontational subject, highlighting major concerns with the way they collect (inherently biased?) data – and the way most of it is used from what could be seen as the Moral High Ground, of being the normative, accepted, medical experts in many societies – and the way this controls the research and practical debates and current and future treatment options in a society.

From a CAM point of view, there are two overall points of interest

Firstly, this focus of ‘medical’ STS on the way that normal ‘conventional medicine/ pharmaceutical approaches’ can sometimes lead to various ‘moral’ issues and a claim to be the only approach to medical knowledge is interesting and insightful, especially on the ethical front.

Emphasis on "Case Studies" to Produce Theory

And secondly the approach they take is almost identical to the approach taken by many CAM research projects over the years:

“What is perhaps different in STS is its predominant emphasis on the use of case studies to produce theory, rather than testing theory using cases; however, this is perhaps a difference in perspective and approach rather than an indication of sharp boundaries between STS and (for instance) anthropology and sociology.”

Conventional Medical Research: Issues?

Some issues regarding conventional medicine and the current ethical research approaches made that Pickersgill mentions are:

“We can likewise say the same of medicine—itself a complex assemblage of knowledge, technology and sociality. Within STS such matrices are objects of study; in particular, STS scholars are attentive to the ways in which citizens are enrolled into bioscience in terms of how individuals and social groups direct research and shape innovation, as well as to how public voices and concerns may be silenced (from the level of the specific research encounter, to scientific governance).”

“As the so-called ‘Science Wars’ of the 1990 s might remind us, influential individuals do not always take kindly to having the ‘black box’ of their work unpacked and its contents inspected. Furthermore, it is clear that STS scholarship in this area does often contain critique; for instance, bioethics has been read as being ‘too close’ to science, compromising its objectivity, and providing legitimacy for controversial scientific endeavours.”

“In regards to the former, methods of visualising the interior of the body—such as magnetic resonance imaging (MRI)–have been shown to be ascribed an authority which encourages their use even when they are costly and do not demonstrate clear therapeutic benefit.

In turn, articulations of benefit itself come to be a function of the nature of disease as mediated and understood through biomedical technique. Such findings prompt further reflection and debate over health care rationing and resource allocation, and access to biomedical innovation.”

“For instance, Petryna’s work on the outsourcing of clinical trials to middle and low income countries has revealed a range of problematic developments, including biased trial designs that ensure drugs look safer and more efficacious, and proceduralism in ethical review and administration that “can hide contextual uncertainties””

“Indeed, as Lakoff has evidenced, trials can contribute to the spread of not solely drugs but the diagnostic categories that they purport to treat (e.g. bipolar disorder).”

“As STS scholars have shown, publics can be both knowledgeable about biomedicine and willing to engage in sustained debate and analysis about issues that bioethicists are grappling with; limiting participation is thus unfortunate not only for democratic reasons, but also because potentially ‘useful’ contributions from those outside the academic remain unheard.”